BASIC PRINCIPLES OF ETHICS
INTRODUCTION:

Ethics is defined as a branch of philosophy that involves systematizing, defining, and recommending concepts of right
and wrong conduct.  Care Team believes the delivery of home care should be based upon fundamental ethical
principles.

There are seven basic Ethical Principles:

  • Beneficence – doing good, caring
  • Non-maleficence – doing no harm
  • Justice – being fair
  • Autonomy – respecting the patient’s right to make decisions
  • Loyalty (Fidelity) – keeping promises
  • Veracity – telling the truth
  • Confidentiality – keeping the patient’s information private

These guidelines are related to:

  • Patient rights
  • Agency rights
  • Patient/family responsibilities
  • Fiscal responsibilities
  • Staff rights
  • Agency/community relationships.

You can put these Ethical Principles into practice by:

  • Respecting the culture and customs of your patients
  • Being truthful in all communication
  • Not speaking badly of patients, co-workers or the Agency
  • Avoiding exploitation of relationships for personal advantage.
  • Not discriminating on the basis of race, color, national origin, disability, or age
  • Assuring the confidentiality of patients – not talking about them to others who do not have “the need to know”
  • Assuring autonomy of patients – letting them participate in deciding their care and treatment

An individual has all the rights, benefits, responsibilities and privileges granted by the constitution and laws of this
state and the United States, except where lawfully restricted.  The individual has the right to be free of interference,
coercion, discrimination and reprisal in exercising these civil rights.

It is the right of every patient to participate in decisions regarding his or her care.

Patients have the right to refuse all or part of their care.  The Staff must inform the patient of the consequences of
such action.

A person providing services shall provide each individual with a written list of their rights and responsibilities, also
known as the BILL OF RIGHTS.   This list must be given to the patient before providing services or as soon after
providing services.  The individual must be informed of changes or revisions to this list.

Care Team has a right to the provision of a safe work environment for all employees.

Care Team’s fiscal responsibilities include:

  • Accepted accounting procedures for billing of services
  • The amount of service billed corresponds to the services provided.

Employees will demonstrate understanding in their responsibilities of:

  • Respecting patient property
  • Listening to concerns and complaints
  • Honoring patient wishes
  • Maintaining patient privacy.

Care Team has the responsibility to see that patient care is not compromised if an employee refuses to participate
because of religious/cultural beliefs.  The patient is then reassigned to an alternate qualified employee.

During orientation, staff members are educated about the process for handling ethical issues.
Ongoing education is provided, as appropriate.

The agency has a functioning process in place to:

  • Promote patient rights and respect
  • Define ethical issues
  • Provide staff education on ethical issues
  • Address and resolve potential or real ethical issues.

Care Team’s mechanisms for the consideration of ethical issues arising in the care of patients are:

  • On a daily basis with the involved staff member and responsible supervisor on a case-by-case basis.
  • Ethical concerns and issues may be submitted in person, by telephone, or in writing to the Administrator,
    Director of Nursing, or the Human Resource Manager.
  • The professionals conducting the investigation will gather facts, ask questions, and determine options or make
    recommendations about the ethical issue to result it.  All proceedings will be strictly confidential.
  • As a result of this investigation, new policies may be developed, and/or additional educational programs created
    for the agency.
•        
BILL OF RIGHTS

Patient Rights are an important and essential part of healthcare today.  All clients come to our Agency with different
healthcare experiences and may or may not be aware of their rights.  Protections are afforded by federal and state
legislation and as health care providers we must educate our client about their rights and the manner in which they
may exercise them.  For ease of access and teaching, the patient’s rights are clearly stated in one document that is
called The Patient’s Bill of Rights. The Bill of Rights must always be accessible to the client, family, public, and staff.  It
can be found posted in the office and in the client’s admission packet.  If a client would like an additional copy, they are
located in the office. Upon admission, the nurse will explain the Bill of Rights to the client and/or caregiver.  The
client/caregiver must be given the opportunity to ask questions.  Receipt of the Bill of Rights is documented in the
clinical record.  The client must also be informed that he/she has the right to excursive the rights at any time without
fear of reprisal.  Any questions about the protections afforded by the Bill of Rights may be directed to the Administrator
or the Director of Nursing if the employee cannot answer it.

KEY AREAS

Key things to remember about the Bill of Rights are:

  • The rights can be exercised at any time.
  • Clients are to receive the best quality care without regard to race, creed, diagnosis, nationality/origin, and
    lifestyle choice.
  • The client/caregiver ALWAYS has the right to refuse care.
  • The client/caregiver must be informed of care prior to initiation.
  • Privacy, including protection of PHI is paramount.
  • The client/caregiver must be informed of charges prior to initiating services.
  • The client has the right to be safe.
  • The client has the right to be treated with respect.
  • The client has the right to make concerns/grievances known without the fear of reprisal.
  • Specific questions about patients’ rights may be directed to the Administrator or the Director of Nursing.

INTERACTING WITH CLIENTS

Client rights not only govern what the client may do and when, but how Agency staff interacts with the client and their
environment.  Appropriate and professional interaction can increase client confidence and overall satisfaction.  When
you are in a client’s home, remember:

  • Address the client using his or her name and the appropriate title.  Nicknames like sweetie and honey are well
    meaning, but it can come across as demeaning.  Terms of endearment should never be used and nicknames
    should only be used if and when the client gives permission.
  • Treat the client’s property with respect.  Remember although you are working, you are in someone’s home!  
    Observe cultural considerations and do not slam doors or damage personal property.
  • Clients have the right to know who you are and what you are doing.
  • Always introduce yourself when you enter into a client’s environment and at the beginning of telephone
    conversations.
  • Always wear your ID badge.
  • Explain procedures prior to starting them.
  • Answer questions honestly.
  • Be professional and smile.

COMPLAINTS / GRIEVANCES

The client has the right to make concerns known.  The Agency has a responsibility to investigate the problem and
resolve the issue to the client’s satisfaction in a timely manner.  Upon admission the client is given a copy of the
grievance process and rights pertaining to having problems resolved.  If a client is upset, it is important to remember:

  • Remain calm and objective.
  • Respond to questions and problems promptly.
  • Do not take complaints personally.
  • Remain professional
  • Do not yell.
  • Do not name call.
  • Do not make accusations.
  • Do not accept or assign blame.

RESPONSIBILITIES

For every right, there is a responsibility to assure that the right is exercised in a safe manner.  As a healthcare
provider, you have the responsibility to:

  • Listen to your patient when they tell you what they need.  Do not assume you know what they need or want.
  • Explain what you are going to do with the patient prior to starting in language that is appropriate for his/her level
    of development/national origin.
  • Be honest.  If you do not know the answer to a question, redirect the question to the office.
  • Remember client privacy!
  • Secure documents with client information.
  • Use the assigned number or initials in place of identifying information when you can.
  • Don’t gossip about clients.
  • Don’t hold conversations with or about clients in public.
  • Encourage independence.

All staff must put client’s safety first.  This may involve having a difficult conversation with a colleague about practice
issues or concerns that compromise patient care.  Practice patterns that place patients at risk must be recognized and
addressed.

Client’s and their family members depend on clinicians to detect and address potential safety issues and to protect
them from preventable harm.  Keeping patients safe serving as patient advocates is critical to achieving that goal.

When acting as an advocate the home care worker must:

  • Be educated, know the client’s rights and offer to be a resource about health problems and treatments.
  • Be object ted; do not include information about your beliefs or value system or personal opinions.
  • Be honest; if you don’t know something, offer to find out.
  • Be reliable, do what you promise to, when you promise to do it.
  • Be supportive, never judge.

Patient Bill of Rights and Responsibilities:

Home care patients have the right to be notified in writing of their rights and obligations before treatment begins and to
exercise those rights.  The patient’s family or guardian may exercise the patient’s rights when the patient is
incapacitated.   Home care providers have an obligation to protect and promote the patient’s rights, including the
following:
Patients have a Right to dignity and Respect
Home care patients and their formal caregivers have a right to not be discriminated against based on color, race
national origin, religion, age, sex, sexual preference or handicap.  Furthermore, patients and caregivers have a right to
mutual respect and dignity, including respect for property.  Care Team’s staff is prohibited from accepting personal
gifts and borrowing money or items form patients.  

Patients have the right:

  • To have your cultural, psychosocial, spiritual and personal values, beliefs and preferences respected.  
  • To have complaints investigated made by the patient, patient’s family or guardian regarding treatment or care
    that is (or fails to be) furnished, or regarding the lack of respect for patient’s property by anyone providing
    services on behalf of Care Team.  You will not be subject to discrimination for doing so.  Care Team must
    document both the existence of the complaint and the resolution of the complaint.  
  • To be informed of the procedure you can follow to lodge complaints with Care Team about the care that is, or
    fails to be, furnished, and regarding a lack of respect for property.  To lodge complaints, call us at (352) 530-
    2862.  
  • To know about the disposition of such complaints.
  • To voice their grievances without fear of discrimination or reprisal for having done so.
  • To be advised of the telephone number and hours of operation of the state’s Home Health Agency hotline, that
    receives complaints or questions about local home care agencies.  The hours are 24 hours a day, seven days a
    week and the telephone number is (800) 962-2873.  The hotline also receives complaints about advance
    directives.  
  • To personal dignity.
  • To effective communication.
  • To be free from mental, physical, sexual and verbal abuse, neglect and exploitation.  
  • To refuse to participate in investigational, experimental, research or clinical trials.   
  • Patient/Agency responsibilities:
  • Notify Care Team of any perceived risks in your care or unexpected changes in your condition, e.g.,
    hospitalization, changes in the plan of care, symptoms to be reported, etc.
  • Notify Care Team if the visit schedule needs to be changed.
  • Notify Care Team of the existence of, and any changes made to, advance directives.
  • Notify Care Team of any problems or dissatisfaction with the services provided.  
  • Provide a safe environment for care.   
  • Follow instructions and express any concerns you have about your ability to follow and comply with proposed
    plan or course of treatment.  Care Team will make every effort to adapt the plan to your specific needs and
    limitations.  If such changes are not recommended, Care Team will inform you of the consequences of care
    alternatives.  
  • Provide accurate and complete information about present complaints, past illnesses, hospitalizations,
    medications and other matters related to the patient’s health.  
  • Know that in the event of an emergency that disrupts Care Team’s services to patients, Care Team will make
    every effort to visit or telephone the patient.  However, if the patient has a medical emergency and is not able to
    contact Care Team, the patient should access the nearest emergency medical facility.
  • Ask questions about care or services when you do not understand your care or what you are expected to do.    
  • Provide feedback about service needs or expectations.
  • Follow Care Team’s rules and regulations concerning patient care and conduct.  
  • Show respect and consideration for Care Team’s personnel and property.  
  • Meet financial commitment agreed upon with Care Team promptly.  
  • Understand and accept consequences for the outcomes if the care and services or treatment plans are not
    followed.  






Revised 6/1/2016 
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